The State of Health in Jordan, 1990–2023: A Systematic Analysis for the Global Burden of Disease Study
Yazan A. Al‐Ajlouni, Jude Alawa, Abdulrahman Al‐Shamari, Aditi Hazra, Kaveh Khoshnood, Omar Shamieh, Nour Makarem, Omar Al Ta'ani, Sara Al Zubi, Adam Coutts, Basile NjeiABSTRACT
Background
Jordan's health system has evolved amid rapid urbanization and the strain of hosting one of the world's largest refugee populations per capita. This study comprehensively evaluates national disease burden trends in Jordan from 1990 to 2023 to inform health priorities.
Methods
Using the Global Burden of Disease (GBD) 2023 framework, we analyzed age‐standardized rates of disability‐adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs) across 370 diseases and 88 risk factors. Data were derived from national censuses, health surveys, disease registries, and hospital records, and harmonized using standardized GBD modeling and estimation procedures. Analyses were stratified by age, sex, and cause.
Results
Between 1990 and 2023, age‐standardized DALYs declined by 33.88% (95% UI: −37.38 to −30.59), with greater reductions in males (−38.83%; −42.22 to −35.60) than females (−27.22%; −31.33 to −23.58). YLLs decreased by 49.38% (−50.93 to −47.68), while YLDs remained comparatively stable (2.49%; −2.37 to 7.47). Using mutually exclusive GBD Level 3 causes, ischemic heart disease and diabetes mellitus were the two leading causes of DALYs in 2023. Diabetes mellitus rose from 7th place in 1990 to 2nd place in 2023, while neonatal disorders declined from 1st to 7th place. Metabolic risks remained important contributors to the overall disease burden. Jordan's age‐standardized diabetes DALY rate in 2023 was approximately 1.56 times the global rate.
Conclusion
Jordan's health profile has shifted toward a greater burden from noncommunicable diseases, while age‐standardized health loss and premature mortality have declined substantially. In contrast, nonfatal disability changed comparatively little. These findings provide an evidence base for primary prevention of NCDs and for long‐term strategies addressing the country's evolving health challenges.